All ETDs from UAB

Advisory Committee Chair

Meredith Kilgore

Advisory Committee Members

Nir Menachemi

Stephen Mennemeyer

Robert Weech-Maldonado

Paul Muntner

Document Type

Dissertation

Date of Award

2015

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

This dissertation focuses on the potential benefits of hypertension (HTN) treatment for the general population and African Americans (AAs) specifically. We undertake three research projects that are interconnected. First, using a systematic review methodology we assess the current state of the cost-effectiveness of HTN treatment literature in order to identify potential gaps in the cost-effectiveness literature, methodological shortcomings, and provide policy makers and researchers with a summary of the current findings as well as methods used in the literature. Second, building off our findings in paper 1, we construct a cost-effectiveness model. We assess the cost-effectiveness of HTN treatment not only for the general population, but also specifically for AAs. We use new model inputs from literature sources and secondary data analysis of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study to account for racial differences in treatment and outcomes of HTN. Finally, patient satisfaction has been shown to be positively associated with medication adherence, therefore, in our third paper, we explore a new pathway for differences in HTN outcomes between whites and AAs: differences in patient satisfaction between hospitals that disproportionately serve minorities and their hospital counterparts.

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